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Technology Use/Management - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Technology Use/Management:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions for Employees Participating in the 360-Feedback Assessment:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to receive feedback from a group of others. As part of this process, you will need to complete a self-assessment questionnaire at this time. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be combined with the responses received from others and a report will be generated for you to foster growth and on-going development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses, and will be not making any changes, click the Complete button.

Competencies Included:
Technology Use/Management, Interpersonal Skills, Adaptability, Action, Continual Learning, Leadership, Managing Performance, Achievement, Negotiation
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team
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Technology Use/Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You communicate results to leadership to inform future technology decisions.
  1. I use technology to boost engineering productivity.
  1. I define clear success metrics for technology initiatives before implementation.
  1. You communicate upcoming technology changes early and clearly.
  1. I use workflow data (such as cycle times, error rates, or throughput) to guide continuous refinement.
If you were to make improvements in Technology Use/Management, what are your suggestions for how you can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are honest about owning up to mistakes made.
  1. You believe honesty and integrity are core tenets of interpersonal relationships.
  1. I assist employees that need help.
  1. I respond quickly to inquiries from potential customers.
  1. You are trusted by peers and co-workers; others are willing to confide in him/her
If you were to make improvements in Interpersonal Skills, what are your suggestions for how you can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You can handle unexpected events without a loss of productivity.
  1. You are flexible and open minded in dealing with others.
  1. You help employees overcome resistance to change so that they can adapt more readily to change circumstances.
  1. You are able to adjust plans as need for implementation of projects.
  1. You are aware of changes to the policies and procedures.
If you were to make improvements in Adaptability, what are your suggestions for how you can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I act immediately instead of waiting for someone else to solve the issue.
  1. You work across organizational lines and boundaries to attain goals.
  1. You fix problems when they occur.
  1. I encourage and support a culture of excellence and continuous improvement within the department.
  1. I take advantage of changes to the current situation.
If you were to make improvements in Action, what are your suggestions for how you can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You pursue learning that will enhance job performance.
  1. You improve on your skill sets.
  1. You seek opportunities to grow in skills and knowledge.
  1. I view setbacks as opportunities to learn from.
  1. You set relevant learning objectives and goals.
If you were to make improvements in Continual Learning, what are your suggestions for how you can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You foster team cooperation, builds trust among team members and creates commitment to team goals.
  1. You set a positive example admired by others.
  1. You voice dissenting opinions in high-stakes meetings, even when unpopular or politically risky.
  1. You ensure that feedback is an ongoing process rather than a once-a-year event.
  1. I avoid vague statements; instead, explaining what works and why or what needs improvement and how.
If you were to make improvements in Leadership, what are your suggestions for how you can improve this?

Managing Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I increase responsibilities for high performing individuals.
  1. You set specific and measurable goals for others and follows through to completion.
  1. You identify employees who consistently demonstrate reliability and entrust them with cross-functional or high-visibility responsibilities.
  1. You assess employee performance against defined standards.
  1. I ensure the employee understands the key tasks, goals and KPIs required for the position.
If you were to make improvements in Managing Performance, what are your suggestions for how you can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You push beyond comfort zones to drive breakthroughs and achieve ambitious outcomes.
  1. I commit to methodical execution, ensuring accountability and sustainable progress toward objectives.
  1. I take calculated risks to achieve significant rewards.
  1. You allocate resources as needed to accomplish organizational goals.
  1. You systematically work to improve the organization
If you were to make improvements in Achievement, what are your suggestions for how you can improve this?

Negotiation

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I clearly understand the interests and choices of both parties.
  1. You shift negotiation tactics when other priorities or constraints become clearer, adjusting the approach to maintain progress.
  1. You understand the expectations of other parties in the negotiation.
  1. You surface areas of partial agreement early and use them as anchors to build momentum toward broader consensus.
  1. I listen to all sides without bias and make fair decisions.
If you were to make improvements in Negotiation, what are your suggestions for how you can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.